IntroductionObesity-related comorbidities are present in young obese children, providing a platform for early adult cardiovascular disorders.ObjectivesTo compare and correlate markers of adiposity to metabolic disturbances, vascular and cardiac morphology in a European pediatric obese cohort.MethodsWe carried out an observational and transversal analysis in a cohort consisting of 121 obese children of both sexes, between the ages of 6 and 17 years. The control group consisted of 40 children with normal body mass index within the same age range. Markers of adiposity, plasma lipids and lipoproteins, homeostasis model assessment-insulin resistance, common carotid artery intima-media thickness and left ventricular diameters were analyzed.ResultsThere were statistically significant differences between the control and obese groups for the variables analyzed, all higher in the obese group, except for age, high-density lipoprotein cholesterol and adiponectin, higher in the control group. In the obese group, body mass index was directly correlated to left ventricular mass (r=0.542; p=0.001), the homeostasis model assessment-insulin resistance (r=0.378; p=<0.001) and mean common carotid artery intima-media thickness (r=0.378; p=<0.001). In that same group, insulin resistance was present in 38.1%, 12.5% had a combined dyslipidemic pattern, and eccentric hypertrophy was the most common left ventricular geometric pattern.ConclusionsThese results suggest that these markers may be used in clinical practice to stratify cardiovascular risk, as well as to assess the impact of weight control programs.
In our study, we found no difference in the prevalence of atrioventricular valve dysplasia between children with and without Down syndrome undergoing complete atrioventricular septal defect repair. This finding contrasts with previously published data, and further confirmatory studies are required. Although clinical outcomes were similar, children with Down syndrome had a significantly higher prevalence of noncardiac complications in the early postoperative period than children without Down syndrome.
Introduction: Pediatric obesity is increasingly prevalent in the Portuguese population. Adipocyte dysfunction results in the expression of pro-inflammatory mediators that are responsible for the low-grade inflammatory process that characterizes obesity. Objectives: The aim of this study was to investigate the relationship between markers of adiposity, inflammation and adipokines in a Portuguese obese pediatric population. Methods: One hundred and twenty children of both sexes, aged 6---17 years, were included in this study. The control group consisted of 41 healthy normal-weight children. The variables analyzed were age, gender, body mass index, waist circumference, fat mass percentage, high-sensitivity C-reactive protein (hs-CRP), leptin and adiponectin. Results: There were significant differences between controls and obese children for all parameters analyzed. In the obese group, after controlling for age and gender, hs-CRP (p=0.041), adiponectin (p=0.019) and leptin (p<0.001) still showed significant statistical differences. A direct correlation was found between hs-CRP, leptin, body mass index and waist circumference, the strongest being with leptin (r=0.568; p<0.001). This trend remained statistically significant, regardless of gender or pubertal age. * Corresponding author. E-mail address: pires1961@gmail.com (A. Pires). Conclusions:Considering the role of leptin, adiponectin and hs-CRP in the genesis of endothelial dysfunction, they may be used in clinical practice for risk stratification, as well as in the assessment PALAVRAS-CHAVEPediatria; Obesidade; Proteína-C-reativa ultrassensível; Adiponectina; Leptina Fatores pró-inflamatórios na obesidade infantil: correlação entre a leptina, adiponectina e proteína C-reativa num grupo de crianças portuguesas obesas Resumo Introdução: A obesidade pediátrica é prevalente na nossa população. A adiposidade resulta na expressão de marcadores pró-inflamatórios que são responsáveis pelo processo de inflamação de baixo grau que caracteriza a obesidade. Objetivos: Tivemos como objetivo avaliar a relação entre marcadores de adiposidade, inflamação e adipocinas num grupo de crianças portuguesas obesas. Métodos: Foram incluídas no estudo 120 crianças obesas, entre os 6 e 17 anos de idade. O grupo controlo continha 41 crianças saudáveis, sem excesso de peso, dentro da mesma faixa etária. As variáveis analisadas foram: idade, género, índice de massa corporal, circunferência abdominal, percentagem de massa gorda, proteína C-reativa ultra-sensível, leptina e adiponectina. Resultados: Todos os parâmetros analisados encontravam-se significativamente mais elevados no grupo de crianças obesas. No grupo obeso, após avaliação por regressão logística, ajustando à idade e género, a proteína C-reativa ultra-sensível (p=0,041), adiponectina (p=0,019) e leptina (p<0,001), mantiveram significado estatístico. Os marcadores de adiposidade correlacionaramse diretamente com a leptina (p=0,001) e inversamente com a adiponectina (p=0,029). Encontrámos também uma correlação direta entre...
Cardiac tumors in the pediatric population are rare, their incidence range between 0.001% and 0.003%. They are mostly benign, rhabdomyomas the most common type, followed by fibromas. The clinical features are being usually nonspecific and depend on the size and location of the tumor within the heart. We report the case of a previously healthy four-year-old boy referred for flu-like symptoms. A respiratory infection was suspected and a chest X-ray showed an increased cardiothoracic index. An echocardiogram revealed a single large heterogeneous mass in the left ventricle emerging from the lateral wall. Despite its size, the mass did not obstruct the left ventricular outflow tract or affect mitral valve function. Cardiac magnetic resonance imaging showed a large mass whose imaging features were suggestive of a fibroma. He became symptomatic during follow-up and was referred for surgical excision of the mass. Histological study confirmed a fibroma. At present the patient remains asymptomatic.
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